Individual provider Active NPI

Dianna Nain-Bradley, LMSW

  • Social Worker
  • Forest Hills, NY
National Provider Identifier
1366639122
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
101624 Issued in NY
Practice address
104 70 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694
Phone
(718) 275-6010
Fax
(718) 275-6062
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 101624 NY Primary

Addresses

Primary practice location

104 70 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694

Mailing address

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694
Phone (718) 275-6010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
101624NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bleuler Psychotherapy Center, Inc. PastSince Mar 10, 1999 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1366639122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694",
            "telephone_number": "718-275-6010",
            "fax_number": "718-275-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 70 QUEENS BLVD",
            "address_2": "SUITE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694",
            "telephone_number": "718-275-6010",
            "fax_number": "718-275-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIN-BRADLEY",
        "first_name": "DIANNA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.